The holder whose full name is WALTS, JIM J,come from MARION IN,hold the Health Facility Administrator license(NO.14000204A) which status is Expired.
| Name | WALTS, JIM J |
|---|---|
| License Number | 14000204A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | MARION |
| State | IN |